期刊
INTERNATIONAL HEART JOURNAL
卷 63, 期 1, 页码 85-90出版社
INT HEART JOURNAL ASSOC
DOI: 10.1536/ihj.21-396
关键词
Acute decompensated heart failure; Diuretic-dependent heart failure; Diuretics; Vasopressin receptor antagonist
The short-term effectiveness of tolvaptan for heart failure has been established, but its long-term effects are still controversial. This study found that the dose of tolvaptan and a history of heart failure admission were significantly associated with rehospitalizations within 1 year. Low-dose tolvaptan may be beneficial in reducing the risk of rehospitalizations.
The short-term effectiveness of tolvaptan (TLV) for heart failure (HF) has been established, but the long-term effects are controversial. We investigated HF patients who could not discontinue both loop diuretics and TLV at discharge from AURORA (Acute Heart Failure Registry in Osaka Rosai Hospital). We compared the following factors at discharge between the RH group. consisting of patients with rehospitalizations due to worsening HF within 1 year after discharge (RH group), and non-RH group: age, gender, blood pressure, history of HF admission, electrocardiogram and echocardiographic parameters, atherosclerotic risk factors, laboratory data, and medications. Furthermore, we compared the effects of long-term low-dose TLV (<= 7.5 mg/day) and high-dose TLV on HF rehospitalizations. The RH group consisted of 81 patients (58.7%). A multivariate analysis revealed that a history of HF admission and the TLV dose were independently and significantly associated with 1-year HF rehospitalizations. A receiver operating characteristic curve revealed that 7.5 mg of TLV was a suitable cutoff value for 1-year HF rehospitalizations. The Kaplan-Meier curves demonstrated that the IT rehospitalization free ratio was significantly higher in the low-dose TLV group (<= 7.5 mg/day) than in high-dose TLV group over 1 year. In conclusion, the TIN dose, in addition to a history of HF admission, was associated with 1-year HF rehospitalizations in diuretic-dependent HF patients. In these patients. long-term low-dose TLV (<= 7.5 mg/day) may be favorable for reducing HF rehospitalizations.
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